Spironolactone reduces severity of obstructive sleep apnoea in patients with resistant hypertension: A preliminary report

Gaddam, K., Pimenta, E., Thomas, S. J., Cofield, S. S., Oparil, S., Harding, S. M. and Calhoun, D. A. (2010) Spironolactone reduces severity of obstructive sleep apnoea in patients with resistant hypertension: A preliminary report. Journal of Human Hypertension, 24 8: 532-537. doi:10.1038/jhh.2009.96


Author Gaddam, K.
Pimenta, E.
Thomas, S. J.
Cofield, S. S.
Oparil, S.
Harding, S. M.
Calhoun, D. A.
Title Spironolactone reduces severity of obstructive sleep apnoea in patients with resistant hypertension: A preliminary report
Journal name Journal of Human Hypertension   Check publisher's open access policy
ISSN 0950-9240
1476-5527
Publication date 2010-08
Year available 2009
Sub-type Article (original research)
DOI 10.1038/jhh.2009.96
Volume 24
Issue 8
Start page 532
End page 537
Total pages 6
Editor G. Y. H. Lip
Place of publication Basingstoke, U.K
Publisher Stockton Press
Collection year 2011
Language eng
Formatted abstract
Obstructive sleep apnoea (OSA) and hyperaldosteronism are very common in subjects with resistant hypertension. We hypothesized that aldosterone-mediated chronic fluid retention may influence OSA severity in patients with resistant hypertension. We tested this in an open-label evaluation by assessing the changes in the severity of OSA in patients with resistant hypertension after treatment with spironolactone. Subjects with resistant hypertension (clinical blood pressure (BP) ≥140/90 mm Hg on ≥3 antihypertensive medications, including a thiazide diuretic and OSA (defined as an apnoea–hypopnoea index (AHI) ≥15) had full diagnostic, polysomnography before and 8 weeks after spironolactone (25–50 mg a day) was added to their ongoing antihypertensive therapy. In all, 12 patients (mean age 56 years and body mass index 36.8 kg m–2) were evaluated. After treatment with spironolactone, the AHI (39.8±19.5 vs 22.0±6.8 events/h; P<0.05) and hypoxic index (13.6±10.8 vs 6.7±6.6 events/h; P<0.05), weight and clinic and ambulatory BP were significantly reduced. Plasma renin activity (PRA) and serum creatinine were significantly higher. This study provides preliminary evidence that treatment with a mineralocorticoid receptor antagonist substantially reduces the severity of OSA. If confirmed in a randomized assessment, it will support aldosterone-mediated chronic fluid retention as an important mediator of OSA severity in patients with resistant hypertension.
© 2010 Macmillan Publishers Limited
Keyword Hyperaldosteronism
Resistant hypertension
Obstructive Sleep Apnoea
Spironolactone
Positive Airway Pressure
Primary aldosteronism
Plasma-aldosterone
Prevalence
Therapy
Failure
Disease
Risk
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ
Additional Notes Published online 17 December 2009

Document type: Journal Article
Sub-type: Article (original research)
Collections: UQ Centre for Clinical Research Publications
Official 2011 Collection
School of Medicine Publications
 
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Created: Sun, 01 Aug 2010, 00:04:20 EST